Distal humeral physeal separation
Pathology
Children < 6
- entire distal humerus physis is displaced
Xray
Distal physis not ossified < 1 year
- may be a difficult diagnosis
arthrogram
Management 6 - 18 months
Two groups of dislocated hips
1. Late presenters
2. Failures of splint in those < age 6/12
Options
1. Adductor tenotomy + closed reduction
- most surgeons will attempt this initially
- risk of AVN wilth forceful reduction / excessive abduction
2. Open Reduction
- for failure of closed reduction
Background
Definition
Developmental dysplasia of the hip
- the femoral head does not have the normal relationship with the acetabulum
- child with subluxable, reducible or irreducible hip
- may not be present at birth (hence not called CDH)
Instability
- ability to dislocate or reduce femoral head into or out of acetabulum
Dislocated
- complete loss of contact